IMCAS

Combined frac microneedling with RF, subdermal HA, epidermal skin boosters plus exosomes for textural improvement and tightening on Asian Skin

Objectives: This study aims to prove the safety and efficacy of combined fractional microneedling with radiofrequency, subdermal hyaluronic acid, epidermal skin boosters plus exosomes for textural improvement and tightening on Asian skin.

Introduction: Various modalities are used to tighten and improve skin texture depending on the patients' skin type, preference and social downtime. Fractional microneedling with radiofrequency and exosomes are two advancing technologies with the ability to induce collagen remodelling and elastin production thus improving wrinkles scars and tightens skin. Subdermal hyaluronic acid promotes remodelling of extracellular matrix thus improvement in skin laxity. Epidermal skin boosters are used to directly supply essential nutrients. Combination of these treatments enhance outcome with the synergistic effect.

Materials / method: cohort study of 35 patients performed in a single center
11 male / 24 female / mean age 43
skin types III-V
total of 2 treatments 4-6 weeks interval
photos and visia imaging were used to monitor

Procedure proper:
1. Topical anesthesia
2. Fractional microneedling with radiofrequency
3. Subdermal HA using BAP technique
4. skin boosters using gauge 34 2mm needle injections periorbital/glabellar/nasolabial/marionette lines
5. exosomes either applied and absorbed through microchannels from frac needliing or with turtle pin
6. Photos and Visia imaging used to rate results

Results: Global aesthetic improvement scale (GAIS) was rated by 3 independent investigators 1-3 months after the 2nd treatment
35% showed very good improvement , 43% showed good improvement

Patient satisfaction was also graded 1-3 months after last procedure
23% were extremely satisfied, 71% were very satisfied

VISIA
Wrinkles = 77% showed an improvement in percentile ranking by mean 26%
Texture = 65.7% showed an improvement in percentile ranking by a mean of 19.26%
Pores = 69% showed an improvement in percentile ranking by a mean of 16.4%

Conclusion: The combination of fractional microneedling, subdermal hyaluronic acid, epidermal skin boosters and exosomes is safe and effective for textural improvement and tightening on Asian skin.

It is recommended that the procedures be repeated after 6-9 months for continuity of results.

Side effects such as redness, waffling, mild bruising are all temporary and resolve on its own.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Full-face treatment with regenerative medicine: New protocol with fractional radiofrequency with microneedles and polynucleotides

Objectives: 1. Create a protocol that combines fractional radiofrequency with microneedles with polynucleotide injection for the treatment of skin quality and facial sagging
2. To study the effectiveness of combining fractional radiofrequency with microneedles with polynucleotide injection
3. To study the safety of combining microneedle fractional radiofrequency with polynucleotide injection

Introduction: Regenerative medicine seeks to activate the repair pathways themselves to "rejuvenate" tissues. This trend has reached aesthetic medicine, combining different non-invasive techniques that avoid the use of fillers and semi-permanent products.
Fractional radiofrequency with microneedles uses energy producing a mechanical and coagulation effect. This device together with the repairing and stimulating power of the polynucleotide can be a safe combination for the treatment of sagging and skin quality, stimulating collagen synthesis and reorganizing it.

Materials / method: 5 patients, 4 women and 1 man (32-56 years old), were treated with fractional radiofrequency with microneedles (800-1500mJ/pulse, monopolar, bipolar mode, 1-2MHz, 500-1000 pulse per patient).All patients were treated with 2ml of polynucleotides (20mg/ml).
3 sessions, 1 per month, were done. The patient was followed up (48h and 1 months after each sessions) by photography, Global Aesthetic Improvement Scale (patient and doctor), standardized scales for glabella, dark circles, sagging and skin quality. Pain was recorded using a visual scale. All adverse events were recorded.

Results: All patients and doctor reported an improvement in sagging and skin quality after first session.
An improvement was observed in all scales, with a greater improvement observed after 2 months.
No serious adverse events were recorded. Erythema and edema disappeared within 48 hours after treatment. One patient had a mild flare-up of folliculitis that resolved without treatment. The bruises or needle marks disappeared in the first 7 days. No infections or hyperpigmentations were observed, not even in patients suffering from melasma.

Conclusion: The combination of fractional radiofrequency with microneedles and polynucleotide infiltration is an effective and safe treatment in improving sagging and skin quality, without the need to use fillers or semi-permanent products. A comparative study with a larger number of patients is needed to prove the superiority of this type of combination with respect to separate treatments and with respect to other semi-permanent products.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Optimizing Advanced Body Sculpting: A Predictable and Safe Algorithm for Maximizing Results with Combination Energy-Based Devices

Objectives: The objective of this presentation is to provide surgeons an algorithm for combining energy based devices in body contouring.

Understand how to combine ultrasound-assisted liposuction, bipolar radiofrequency, and cold helium plasma RF for advanced body sculpting.

Develop a roadmap to determine energy levels and end points for each device, ensuring predictable and safe outcomes.

Learn how to tailor energy protocols based on patient characteristics, treatment areas, and tissue response.

Enhance precision and safety in combining energy platforms to maximize results while minimizing risks

Introduction: The advent of energy-based devices like ultrasound-assisted liposuction, bipolar radiofrequency, and cold helium plasma RF has revolutionized body sculpting, each offering unique benefits. However, despite their popularity, there remains no general consensus on how to use these devices in combination for optimal results. More importantly, there is limited guidance on adjusting protocols for different patient profiles and treatment areas, leaving many practitioners seeking a clear roadmap for effective, personalized use.

Materials / method: In developing this algorithm, patient factors such as age, pregnancy history, ethnic background, tobacco use, skin quality, prior surgeries, and the treatment area were evaluated and assigned a score. This scoring system was used to assess how different energy-based devices—ultrasound-assisted liposuction, bipolar radiofrequency, and cold helium plasma RF—perform in combination. By analyzing these scores, we determined which device combinations yield optimal skin retraction and contouring results for various patient profiles.

Results: The number of pregnancies was the most significant predictor of tissue response to combination energy treatments. Patients in their 50s showed a lesser response to the energy platforms. In the extremities, ultrasound-assisted liposuction combined with bipolar radiofrequency yielded the best tissue contraction and skin texture. Patients of Middle Eastern and Northern European backgrounds had suboptimal outcomes compared to their Latino and Asian counterparts. These findings emphasize the need to tailor energy use based on individual patient factors for optimal results.

Conclusion: Navigating multimodality therapies in body sculpting can be challenging, as improper use of devices in the wrong scenarios may lead to less-than-ideal results. To fully optimize combination therapies, it’s crucial to tailor treatments to each patient’s unique characteristics, including age, pregnancy history, tobacco use, ethnicity, and treatment area. This study is the first to explore how these factors influence device selection, helping identify candidates suited for liposculpting versus those who may need excisional surgery, ensuring better outcomes and safety.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Elevating Social Perception: Multimodal Strategies for Addressing Aesthetic Patients’ Status-Driven Concerns

Objectives: This presentation aims to review the literature on the relationship between facial structure, skin quality, and social class perception across various racial and cultural backgrounds. It will explore how these factors influence perceptions of professionalism, status, and luxury. The session will also demonstrate how to apply this knowledge in clinical practice, focusing on non-surgical multimodal approaches to help patients achieve a more professional and elevated social appearance.

Introduction: This presentation will explore the implications of the recent study by Bjornsdottir et al. (2024), which highlights how stereotype-related facial features drive social class perception. By interpreting these findings, we will inspire new treatment protocols using non-surgical multimodal approaches to enhance patients' perceived social status. The session will also feature a 20-case series with before-and-after photos, evaluated by third-party observers to summarize changes in social status perception scores.

Materials / method: **Materials:**
- 20 patients seeking enhanced social status perception.
- Non-surgical modalities: botulinum toxin, dermal fillers, laser treatments, and radiofrequency skin tightening.
- Standardized before-and-after photography.

**Methods:**
- Customized treatment plans based on facial features linked to social status.
- Multiple sessions with selected modalities to improve skin quality, structure, and harmony.
-Pre and Post-treatment photos evaluated by 50 third-party observers for social status changes.
- Data analyzed to assess treatment effectiveness.

Results: In this pilot study, the social status scores, as evaluated by third-party observers, showed a statistically significant increase in the after photos compared to the before photos. This suggests that the non-surgical multimodal treatments effectively enhanced the perceived social status of the patients. The full results and comprehensive analysis are expected to be completed by October 2024, providing further insights into the impact of these aesthetic interventions on social perception.

Conclusion: Manipulation of specific facial features and facial outlines, as supported by the literature on social status perception, can serve as a valuable guideline in aesthetic practice. By understanding how these features influence perceptions of social status, trustworthiness, and professionalism, practitioners can better tailor treatment plans to meet patients' aesthetic goals. This approach facilitates informed discussions with patients whose chief complaints relate to enhancing their perceived social standing and professional image through targeted non surgical aesthetic interventions.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Combination of Fractional Picosecond Laser (FPL) and Rose Stem Cell-Derived Exosomes (RSCEs) for Acne Scar Treatment: A Split-Face Pilot Study

Objectives: To assess the clinical efficacy and safety of RSCEs combined with Fractional Picosecond Laser (FPL) in reducing atrophic acne scars, by evaluating post-treatment recovery, scar severity reduction, and adverse effects.

Introduction: Fractional Picosecond Laser (FPL) has proven effective in treating atrophic acne scars. However, improvements in post-treatment recovery and overall efficacy are still needed. Stem cell-derived exosomes have shown promise as a cell-free treatment, aiding in tissue regeneration and recovery. Recently, there has been growing interest in plant-based exosomes, such as Rose Stem Cell-Derived Exosomes (RSCEs), which offer similar regenerative benefits. This study explores the synergistic effects of FPL and RSCEs in the treatment of atrophic acne scars.

Materials / method: A 12-week, double-blind, randomized, split-face pilot study was conducted on patients with atrophic acne scars. Patients received three Fractional Picosecond Laser sessions with dual low and high fluences at 4-week intervals, followed by a 4-week post-treatment evaluation. RSCEs were applied to one side of the face and a control gel to the other. Clinical assessments included digital photography, Investigator's Global Assessment (IGA) ratings, biometric camera evaluations, and monitoring of recovery, erythema, pain, and downtime.

Results: The RSCE-treated side showed a significantly greater reduction in acne scar severity scores compared to the control side. RSCE-treated sides also exhibited milder erythema, shorter recovery times, and reduced post-treatment pain. No severe adverse effects were observed. The improvement in scar appearance was more pronounced on the RSCE-treated sides at follow-up visits, with enhanced skin texture and fewer residual scars.

Conclusion: The combination of FPL and RSCEs provides a safe and effective treatment for atrophic acne scars, promoting faster recovery and superior scar improvement compared to standard treatments. RSCEs, as a plant-based exosome therapy, show great potential for broader use in aesthetic and regenerative dermatology.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Bone and Fat Pad Restoration Using CMC Combined with HA Innovative Approaches in Facial Rejuvenation

Objectives: Bone and Fat Pad Restoration Using CMC Combined with HA Innovative Approaches in Facial Rejuvenation

Introduction: The aging process affects facial structure at multiple levels including skin, fat, and bone, necessitating effective restoration techniques.
Current strategies predominantly focus on skin and fat replacement using CMC and HA fillers.
However, this publication introduces a novel concept of "bone projection," addressing the structural impact of bone loss on facial aging.
By respecting natural anatomical fat pads and supporting collapsed anatomical structures, our approach evaluates MRI data on facial skeletal aging to target key areas such as the chin, zygomatic arch, jawline, temples.

Materials / method: From May 2022 to February 2024, a study involving 21 cases employed a new modeling technique using deep CMC injections aimed at restoring age-related bone atrophy.
Material placement at the periosteum's edge marked the bone restoration boundary. Following this, HA fillers of high
viscosity were strategically injected using specialized cannulas or needles to replace volume loss.
Each case received a maximum volume of 6-8 ml per session, with HA containing Lidocaine to minimize discomfort.

Results: The advantage of using cross-linked CMC, unlike HA, is its reduced propensity for edema, facilitating precise evaluation of bone restoration.
Sequential injections addressed fat pad losses, utilizing high-viscosity HA for deep compartments and lower density formulations for subdermal layers.
Minimal pain was reported during injections, with no adverse reactions noted post-procedure.
Follow-up evaluations at 2, 7, and 10 days revealed stable outcomes without the need for painkillers, antibiotics, or topical treatments.

Conclusion: CMC cross-linked filler demonstrates efficacy in bone restoration alongside HA for addressing higher-level fat pad losses, with no observed interactions or complications.
Safe practices, including meticulous anatomical considerations during injections, contribute to enhanced outcomes in bone volume restoration from skin to underlying structures.
Plans for managing potential vascular embolism risks involving immediate dissolution strategies for both CMC and HA further ensure procedural safety.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability Gkritzalas Konstantinos, Dermatologist, Master Aesthetic Medicine, Clinica Arbe Milano, Italy; German Clinic KW

The Association of Full Face Phenol-Croton Peel Simultaneously Wilhelm Bleparoplasty and Surgical Eyebrow Repositioning

Objectives: Blepharoplasty alone is insufficient to provide rejuvenation of the entire face, requiring a combination of treatments. Thus, phenol-croton peel is capable of treating wrinkles and blemishes and can be performed at the same time as ophthalmoplastic surgery. The clinical case aims to demonstrate the effectiveness of the combination of full face phenol-croton peel performed at the same time as eyelid surgery. Blepharoplasty and Castañares surgery were performed followed by full face phenol-croton peel. The patient presented a very satisfactory result of facial rejuvenation.

Introduction: Aging occurs throughout the face and therefore we do not obtain satisfactory facial rejuvenation results when treating a single anatomical area. Despite blepharoplasty being one of the first surgeries performed in rejuvenation, isolated treatment of the eyelid is not capable of rejuvenating the entire face, being necessary to combine treatments. In this sense, phenol-croton peel is a treatment that greatly reduces wrinkles and improves skin quality and can be performed at the same time as oculoplastic surgery, bringing comfort to the patient and more satisfactory facial rejuvenation.

Materials / method: On June 24, 2024, at the Hospital Instituto de Olhos de Belo Horizonte (IOBH) - Brazil, upper blepharoplasty and lower transconjunctival blepharoplasty were performed with repositioning of the eyebrows using Castañares surgery. A full face phenol-croton peel was carried out in sequence, with a concentration of 1% croton oil on the forehead, glabella, nose and perioral region and 0.6% croton oil on the rest of the face. The procedures were performed in the operating room, under sedation and cardiac monitoring, intravenous hydration and monitored by an anesthesiologist.

Results: The patient was followed for the next six months. He did not present any type of complications or procedural complications and did not report any complaints. She had facial erythema for approximately 4 months, as expected. The patient presented very satisfactory results of complete facial rejuvenation after 6 months of treatment.

Conclusion: The combination of treatments is necessary to obtain the best results from full face facial rejuvenation. In this sense, the association of phenol-croton peel with oculoplastic surgery brought very satisfactory results, in addition to providing more convenience and savings to the patient due to the possibility of being performed at the same surgical time.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Skin Ageing and Morphotypes: Expanding Skin Quality Possibilities

Objectives: The objective of this presentation is to explore the benefits of combining fine line fillers with dermal restructuring techniques for treating skin ageing, focusing on the impact of skin morphotypes on optimizing outcomes. This presentation aims to showcase how personalized treatment plans, tailored to different skin morphotypes, enhance the efficacy of anti-ageing interventions. Attendees will learn about the synergistic effects of these combined treatments and the importance of customized care in achieving superior aesthetic results and patient satisfaction.

Introduction: Skin ageing manifests as fine lines, wrinkles, and structural changes, influenced significantly by morphotypes, or distinct skin phenotypes. This presentation explores the synergistic effects of combining fine line fillers with dermal restructuring techniques. By tailoring these treatments to various skin morphotypes, we aim to enhance skin quality and achieve superior rejuvenation outcomes. This approach highlights the importance of personalized care in addressing the diverse ageing patterns across different skin types.

Materials / method: Methods:

A comprehensive review of clinical studies and trials was conducted, focusing on the efficacy of fine line fillers and dermal restructuring treatments, including mesotherapy, peels, and radiofrequency, across different skin morphotypes. Patient outcomes, such as skin texture, elasticity, and overall aesthetic improvement, were analyzed to determine the optimal integration of these treatments. This approach aimed to identify the most effective combinations tailored to specific morphotypes, enhancing personalized treatment strategies for superior anti-ageing results.

Results: The findings reveal that combining fine line fillers with dermal restructuring techniques, such as mesotherapy, peels, and radiofrequency, offers superior results compared to single-modality treatments. This integrated approach addresses superficial lines and deeper structural changes, enhancing skin smoothness, firmness, and a youthful appearance. Customizing treatments according to skin morphotypes maximizes efficacy and minimizes adverse effects. Comparisons of age groups show that patients receiving combination treatments of fine line fillers and dermal restructuring achieve better result

Conclusion: Integrating fine line fillers with dermal restructuring techniques, tailored to skin morphotypes, expands the possibilities for improving skin quality and reversing signs of ageing. This personalized treatment strategy is promising for aesthetic practice, offering effective, individualized solutions for diverse patient needs. Future research should refine these treatments, focusing on long-term efficacy and safety. Advancements in technology and understanding skin biology will further enhance these tailored approaches, ensuring optimal patient outcomes and satisfaction.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Combined therapies for vulvar lichen

Objectives: To investigate the effectiveness and safety of combined therapies in the treatment of vulvar lichen, this lecture aims to: 1) Provide an overview of vulvar lichen, including its etiology, pathophysiology, and clinical manifestations. 2) Discuss current combined therapeutic approaches 3) Evaluate clinical outcomes, focusing on symptom relief, disease progression, and quality of life.

Introduction: Vulvar lichen is a chronic inflammatory condition that significantly affects the vulvar region, leading to symptoms such as itching, pain and scarring. Standard single-modality treatments often fail to achieve sustained disease control. Recent advances suggest that combined therapeutic approaches may offer superior outcomes by targeting multiple pathogenic mechanisms. This lecture introduces the rationale for using combined therapies, the potential benefits of synergistic effects, and the importance of individualized treatment plans.

Materials / method: During the lecture I will present cases of my patients who suffered from different types of vulvar lichen (planus, simplex chronicus, sclerosus). I will present symptoms of their diseases, their previous medical history and results of my treatment. In every case I used combined therapies. Every patient had individual treatment plan.

Results: Combination of traditional treatment with regenerative gynecology shows very promising results. Data indicate that combined therapy results in better symptom control and reduced recurrence rates compared to monotherapy. Improvements in patient-reported outcomes, such as quality of life and sexual function, are noted.

Conclusion: Regenerative gynecology offers a promising avenue for the treatment of vulvar lichen, with therapies like PRP, hyaluronic acid, stem cell therapy, laser treatments showing significant potential. These innovative approaches aim to heal and regenerate vulvar tissue, providing relief from symptoms and improving quality of life for patients. As research advances and more clinical data become available, regenerative techniques may become a cornerstone in the management of vulvar lichen.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Labia majora Rejuvenation by plasma gel plus polycaprolactone filler

Objectives: Autologous platelet poor plasma gel injection seems to be a cost-effective, safe, well-tolerated, and minimally invasive technique producing significant aesthetic correction of labia majora wrinkles and augmentation

Introduction: Female external genitalia lose elasticity and volume with age, and start to lose fatty tissue, get wrinkled. This is why many patients seek on some kind of labia majora augmentation and rejuvenation. Currently, lipofilling and hyaluronic acid (HA) based injections are two most popular methods for this purpose. The first is invasive and need operation room and the second one is expensive and both of them absorb rapidly.

This study aims to evaluate the effectiveness and safety of labia majora rejuvenation with a new method by bi-filler {plasma gel) plus polycaprolactone-based filler fallowed P

Materials / method: This is a prospective single group pilot study that was performed on 20 female patients desiring labia majora rejuvenation. All patients were complained about hypotrophy and hyperpigmentation of the labia majora. After taking written informed consent, they received two sessions of plasma gel plus polycaprolactone (PCL) based filler injections in subcutaneous layer and fallowed by PRP in intradermal layer at the same time in each labia majora at 3-month interval. They were assessed clinically before treatment sessions and at the end of follow-up period (6th month).

Results: All patients showed immediate significant clinical improvement after injection that maintained till the end of follow-up period. This finding was confirmed by significant reduction in the mean values of Wrinkle Severity Rating Scale (WSRS) and significant improvement of skin homogeneity and texture with slightly augmentation and bulking with high Visual Analog Patient Satisfaction Scale (VAS) score. In general, the reported side effects were minimal and transient.

Conclusion: Autologous platelet poor plasma gel injection seems to be a cost-effective, safe, well-tolerated, and minimally invasive technique producing significant aesthetic correction of labia majora wrinkles and augmentation.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Nearly Scarless Necklifts

Objectives: The neck is typically one of the earliest and most obvious signs of facial aging. Facelift techniques can provide significant improvement with discreet scars. Patients are increasingly seeking non-surgical options to avoid any scars. Neck rejuvenation is now possible using non and minimally invasive techniques leaving no significant scars. Presented is an algorithm for the analysis of the aging neck. Treatment options including non and minimally invasive techniques are discussed. Results of these techniques are shown.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Collagen hybridization

Objectives: Skin aging is a complex process influenced by various intrinsic and extrinsic factors, necessitating a comprehensive treatment approach. This paper presents a novel multi-modal strategy integrating Fractional RF, IV therapy, topical cosmeceuticals (e.g., retinoids), injectable medications (e.g., Hyaluronic acid skin boosters, polyneucleotides), biostimulators (e.g., PLLA), and oral collagen supplementation for addressing diverse aspects of skin aging. Through individualized treatment dosages tailored to specific patient needs such as laxity, wrinkle severity, and skin depression leve

Introduction: Skin aging is a multifaceted process driven by intrinsic factors like genetics and hormonal changes, as well as extrinsic factors such as UV exposure, pollution, and lifestyle choices. These factors collectively contribute to signs of aging, including wrinkles, skin laxity, and uneven texture. Traditional single-modality treatments often fall short in addressing the complex nature of skin aging. Therefore, a comprehensive, multimodal approach is essential for effective rejuvenation.

Materials / method: During our practice we utilized a multimodal protocol, combining regenerative medicine, injectable treatments, and at-home care with specific values to achieve optimal patient recovery. The study was conducted at the clinic focusing on patients presenting diverse skin aging concerns. The multimodal protocol included:
1Fractional RF: Utilized to stimulate collagen production and improve skin texture and firmness.
2. IV Therapy Administered to enhance overall skin health and hydration.
3. Topical Cosmeceuticals: Including retinoids to promote cell turnover and

Results: Multimodal treatment are now considered the new standard of care

We include patients results who completed the treatment protocol over a period of six months until 3 years.
Individual treatment plans should be adapted according to the physician’s competence and the patient’s preferences. Combination treatments show enhanced and longer-lasting results compared to single-agent or single-technique protocols, without any clinical evidence of increased adverse EVENTS. No guidelines for pan-facial combined approach have been published

Conclusion: The human body functions as a whole
Aging is multifactorial, and treatment should be comprehensive
A healthy body is the foundation of a beautiful face
The approach to treatments is increasingly focused on comprehensive management

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Enhancing Facial Rejuvenation: The Role of Hybrid Biostimulants in Combination with 1470m Diode Laser and MFU-V

Objectives: To evaluate the efficacy and safety of hybrid biostimulant treatments when combined with the 1470m diode laser and MFU-V. The aim is to improve facial aesthetic outcomes through enhanced biostimulation, skin tightening effects, and overall contouring improvements.

Introduction: The demand for effective facial aesthetic rejuvenation has risen significantly in recent years, prompting the exploration of innovative combination treatments. This study specifically examines the use of hybrid biostimulants in conjunction with a 1470m diode laser with subcutaneous fiber and MFU-V across a series of 400 cases.

Materials / method: We conducted a retrospective analysis of 400 patients who received hybrid biostimulant Harmonyca injections combined with energy-based devices and lasers. In the same session, 34 patients underwent treatment with the 1470m diode laser (Endolift - Eufoton), while 67 patients received MFU-V (Ulthera - Merz Aesthetics). The average volume of Harmonyca used per patient was 2.5 ml, with a mean of 450 MFU-V shots administered per treatment session. Additionally, treatments with Harmonyca were performed alongside other modalities, including fillers and energy-based devices (EBD).

Results: This study represents one of the largest series analyzed, providing valuable insights into the real-life applications of the Harmonyca product. The combination of Harmonyca with the 1470m diode laser and MFU-V demonstrated significant improvements in skin tightening, contouring, and overall patient satisfaction. Detailed satisfaction rates indicated that over 94% of patients reported being satisfied with the results. Moreover, 87% of patients expressed a willingness to recommend the treatment to others. The biostimulant properties of Harmonyca notably enhanced overall aesthetic improvement.

Conclusion: his 400-case series highlights the effectiveness and safety of utilizing hybrid biostimulants in conjunction with the 1470m diode laser and MFU-V for facial aesthetic rejuvenation, demonstrating favorable safety and efficacy results. Detailed values for Endolift will be presented in the presentation. The findings emphasize the benefits of multimodal approaches in achieving optimal results, supporting further research and clinical application in the field.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): Dr. Emre Kaynak is a Allergan Medical Institue Trainer

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Neck rejuvenation with injectable combinations

Objectives: Showing the different neck layers that get affected with aging and how to combine treatments to treat all the different layer deteriorations.
Simplifying the neck anatomy and aging effect and show different treatment options.
Show different treatment options demonstrate which layer would benefit from it & best vs worst patient for each treatment.
Show how to check for which layers are deteriorated to combine the proper treatment including fillers, Toxin, bio-stimulators, skin booster, lipolysis, thread lift and lasers for best results.

Introduction: Most women care the most of their faces but many of them they forget about their neck making it the only mark that show their true age.
Different layers of the neck are affected with aging, including the skin, Muscles (platysma), Fat (subcutaneous and sub-platysma fat ) that leads to skin discoloration roughness and sagging, neck bands , double chin and loss of the sharp definition of the jawline and cervico-mental angle become wide all these changes coming form different layers requires combining treatment that targets all the affected layers to get the best results.

Materials / method: Starting form deep to superficial first: Lipolysis for the Superficial fat herniation , then ,Botulinum toxin which is very effective ONLY with hyperactive strong platysma with strong bands and horizontal lines reduction, Nefertiti lift as well improve the neck and jawline with proper patient selection. Finally the skin quality improvement : using Skin boosters and or biostimulators ( Ca hydroxyapatite, PLLA, or Profhilo), mesolifting material,PRP , lasers and LBDs, as well as PDO thread lifts are all very effective to get better quality of the skin.

Results: Combining Toxin and Biostimulators with botulinum toxin, Lasers or threads is far more is effective then using one of these treatments as the cause is always combined in the different neck layer.
Always nonsurgical options show good results only with mild to moderate neck aging.
Comparing different combinations 2 sessions of Ca Hydroxyapatite to Profhilo 3 sessions (Very close results).
Combining Meso lipolysis followed by Jawline fillers, or threads, depending on the amount of sagging and skin elasticity.

Conclusion: With sever muscle laxity & advanced sagging avoid toxin injection, surgery is usually the best option.
With mild to moderate sagging with strong platysma combininf biostimualtor with toxin is very effective. also lasers & thread lifts are very effective.
Always start from deep to superficial with the neck ( Sub cutaneous fat dissolve, then , botulinum toxin for the muscle, then skin enhancers and biostimulators).
Keep in mind with advanced laxity, muscle laxity surgery remain the best option.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

New possibilities of minimally invasive combined techniques in the treatment of facial asymmetry

Objectives: The purpose of this presentation is to demonstrated the possibility of symptomatic treatment in patients with facial hemiplegia using a combination of minimally invasive methods that allow to achieve an aesthetic effect resulting not only in the achievement of facial symmetry but also improvement in quality of life due to enhancement of the chewing function, speech and eyelid closure.

Introduction: Facial asymmetry is a common problem encountered in the clinical practice of neurologists and surgeons. It can be congenital, post-traumatic or a consequence of various diseases, which lead to facial nerve palsy.
The consequences are functional and aesthetic but also psychological disorders related to the patient's impaired communication with the environment, which increases depression and lowers self-esteem.
In the presentation, the author's own experience of treating facial asymmetry in more than 90 patients with permanent peripheral facial nerve palsy is presented.

Materials / method: All procedures were performed by the author of the presentation on patients with facial asymmetry after permanent facial nerve palsy caused by disease or trauma. Used methods: implantation of soluble P(LA/CL) and permanent lifting threads (polypropylene) for soft tissue lift on the paralyzed side in combination with botulinum toxin treatment (to correct hyperkinesia on the healthy side) and lipofiling in patients with lipodystrophy and tissue flaccidity.

Results: The result of the applied treatment is the achievement of facial symmetry followed by improvement of chewing, speech and eyelid closure functions.

Conclusion: The experience of the author of this presentation shows the high effectiveness of using P(LA/CL) threads as a method of minimally invasive facial symmetrization in facial nerve palsy. Through their use, both aesthetic and functional aspects can be affected, significantly improving the patient's quality of life. In order to achieve satisfactory treatment results, the most important thing is the individual approach to the patient and the ability to combine techniques using lifting threads with other therapeutic options : lipotransfer , botulinum toxin injections or / and hyaluronic acid.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): APTOS

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

A Combined Technique for Gluteal Beautification: Aesthetic Enhancement and Biostimulation

Objectives: To present the technique and clinical outcomes of a combined approach for gluteal beautification, focusing on both augmentation and biostimulation effects

Introduction: : In clinical practice, gluteal augmentation has evolved to meet the growing demand for both immediate aesthetic improvement and enhanced tissue quality. A combined technique using hyaluronic acid-based fillers for volumization and calcium hydroxyapatite-based biostimulators for collagen stimulation offers a comprehensive approach to gluteal contouring. This method aims to achieve immediate volume augmentation while promoting long-term improvements in skin firmness and elasticity.

Materials / method: The technique involves the initial injection of a hyaluronic acid-based filler for volume enhancement, followed by a calcium hydroxyapatite-based biostimulator to stimulate collagen production and improve tissue quality. This approach has been used to provide natural, harmonious gluteal contouring with long-term benefits.

Results: Clinical observations indicate satisfactory volume enhancement with significant improvement in skin texture and firmness over time. Patients expressed high satisfaction with both the immediate aesthetic outcomes and the progressive enhancement of skin quality.

Conclusion: The combined use of a hyaluronic acid-based filler and a calcium hydroxyapatite-based biostimulator for gluteal augmentation provides a balanced approach, delivering both immediate volume and sustained tissue improvement. This technique offers a promising option for clinicians seeking to optimize aesthetic outcomes and enhance long-term skin quality.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Hours	Speakers	Lecture title	Abstract	Number
10:00	Dr Victoria G BELO	Combined frac microneedling with RF, subdermal HA, epidermal skin boosters plus exosomes for textural improvement and tightening on Asian Skin	View	140702
10:09	Dr Adriana RODRIGUEZ VALERA	Full-face treatment with regenerative medicine: New protocol with fractional radiofrequency with microneedles and polynucleotides	View	144905
10:18	Dr Alireza TEHRANI	Optimizing Advanced Body Sculpting: A Predictable and Safe Algorithm for Maximizing Results with Combination Energy-Based Devices	View	140703
10:27	Dr Smith ARAYASKUL	Elevating Social Perception: Multimodal Strategies for Addressing Aesthetic Patients’ Status-Driven Concerns	View	140704
10:36	Dr Suparuj LUEANGARUN	Combination of Fractional Picosecond Laser (FPL) and Rose Stem Cell-Derived Exosomes (RSCEs) for Acne Scar Treatment: A Split-Face Pilot Study	View	140705
10:45	Dr Konstantinos GKRITZALAS	Bone and Fat Pad Restoration Using CMC Combined with HA Innovative Approaches in Facial Rejuvenation	View	140706
10:54	Dr Marina QUEIROZ	The Association of Full Face Phenol-Croton Peel Simultaneously Wilhelm Bleparoplasty and Surgical Eyebrow Repositioning	View	140709
11:03	Dr Michelle WESTCOTT	Skin Ageing and Morphotypes: Expanding Skin Quality Possibilities	View	140710
11:12	Dr Karina BARSZCZEWSKA	Combined therapies for vulvar lichen	View	140708
11:21	Dr Sara NOROUZI	Labia majora Rejuvenation by plasma gel plus polycaprolactone filler	View	140711
11:30	Dr Adam RUBINSTEIN	Nearly Scarless Necklifts	View	142813
11:39	Dr Dagne PUPO	Collagen hybridization	View	140712
11:48	Dr Mehmet CIMEN	Enhancing Facial Rejuvenation: The Role of Hybrid Biostimulants in Combination with 1470m Diode Laser and MFU-V	View	142811
11:57	Dr Nadine HAMADA MOUSTAFA	Neck rejuvenation with injectable combinations	View	142812
12:06	Dr Bozena JENDRYSIK	New possibilities of minimally invasive combined techniques in the treatment of facial asymmetry	View	140707
12:15	Dr Renato PAZZINI	A Combined Technique for Gluteal Beautification: Aesthetic Enhancement and Biostimulation	View	144906
12:24		Q&A		140713

IMCAS World Congress 2025
Program

FOCUS ON

Combined treatments - Contributed talks

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2025 Program

FOCUS ON

Combined treatments - Contributed talks

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2025
Program